Stögbauer Fabian, Wirth Markus, Lauterbach Maren, Wollenberg Barbara, Schmidl Benedikt, Hoch Cosima C, Ourailidis Iordanis, Hess Jochen, Eckstein Markus, Hartmann Arndt, Iro Heinrich, Gostian Antoniu-Oreste, Balk Matthias, Jesinghaus Moritz, Ribbat-Idel Julika, Sailer Verena-Wilbeth, Perner Sven, Bruchhage Karl-Ludwig, Hoffmann Markus, Lükewille Lukas, Stuhlmann-Laeisz Christiane Maria, Röcken Christoph, Mogler Carolin, Budczies Jan, Boxberg Melanie
Technical University of Munich, TUM School of Medicine and Health, Institute of General and Surgical Pathology, Munich, Germany.
Department of Otolaryngology, Head and Neck Surgery, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
Br J Cancer. 2025 Feb;132(2):212-221. doi: 10.1038/s41416-024-02912-3. Epub 2024 Nov 29.
We aimed to validate the prognostic significance of tumor budding (TB) in p16-positive oropharyngeal squamous cell carcinomas (OPSCC).
We analyzed digitized H&E-stained slides from a multicenter cohort of five large university centers consisting of n = 275 cases of p16-positive OPSCC. We evaluated TB along with other histological parameters (morphology, tumor-stroma-ratio, lymphovascular invasion (LVI), perineural invasion) and calculated survival outcomes using both univariate and multivariate analyses.
TB was identified as an independent prognostic parameter, with TB-high cases showing inferior outcomes in univariate (HR: 3.08, 95%-CI: 1.71-5.54) and multivariate analyses (HR: 4.03, 95%-CI: 1.65-9.83). Similarly, LVI remained an independent prognostic factor (HR: 3.00, 95%-CI: 1.22-7.38). A combined classification including TB and LVI stratified cases into low-, intermediate- and high-risk categories. We could not detect correlations between TB and the number of lymph node metastases or between TB and an extracapsular extension of lymph node metastases.
In addition to LVI, we could identify TB as an independent prognostic factor in p16-positive OPSCC in this multicenter study cohort. Thus, evaluating TB along with LVI in a combined scheme for prognostication might help to establish a more personalized treatment regimen for patients with p16-positive OPSCC.
我们旨在验证肿瘤芽生（TB）在p16阳性口咽鳞状细胞癌（OPSCC）中的预后意义。
我们分析了来自五个大型大学中心的多中心队列中数字化的苏木精-伊红（H&E）染色切片，该队列包括n = 275例p16阳性OPSCC病例。我们评估了肿瘤芽生以及其他组织学参数（形态学、肿瘤间质比、脉管侵犯（LVI）、神经周围侵犯），并使用单因素和多因素分析计算生存结果。
肿瘤芽生被确定为一个独立的预后参数，在单因素分析（风险比：3.08，95%置信区间：1.71 - 5.54）和多因素分析（风险比：4.03，95%置信区间：1.65 - 9.83）中，肿瘤芽生高的病例显示出较差的预后。同样，脉管侵犯仍然是一个独立的预后因素（风险比：3.00，95%置信区间：1.22 - 7.38）。包括肿瘤芽生和脉管侵犯的联合分类将病例分为低、中、高风险类别。我们未检测到肿瘤芽生与淋巴结转移数量之间或肿瘤芽生与淋巴结转移的包膜外扩展之间的相关性。
在这项多中心研究队列中，除了脉管侵犯外，我们还能确定肿瘤芽生是p16阳性OPSCC的一个独立预后因素。因此，在联合方案中同时评估肿瘤芽生和脉管侵犯以进行预后判断，可能有助于为p16阳性OPSCC患者制定更个性化的治疗方案。
